is Paxil a safe drug? Please help!!!

To all

If there is anyone with any information on this, Please respond ASAP!

I know someone who has recently been taking Paxil and there has been a significant change in his personality in the last 6 months. He also loves his beer and has often mixed both and tried to get off of Paxil many times. This has resulted in two suicide attempts. His doctor seems to think this is because he mixed. I have read some info on the net that states that this is a “weasel of a drug” but many are also promoting their own products or have their own agendas.

Does anyone Have any information on this or any links that they could provide.

any help would be much appreciated.

Thanks
Joe29

You shouldn’t drink while taking anti-depressants. Going off Paxil should be done under a doctor’s supervision. It’s a bad idea to go off it cold turkey.

SSRIs are in general fairly safe and well tolerated. However, a person with bipolar disorder, a seizure disorder, and/or other medical conditions may experience complications.

One should definitely not drink on SSRIs or other psych meds, as there will be significant interaction effects. One should also not quit a med cold turkey or without supervision, as the rebound effect can be detrimental.

If this friend does not like Paxil, or it is affecting him badly, he should speak to his psychiatrist or doctor about a medication change. If he has difficulty with his doctor, perhaps he can consider a change in provider so he can have a better working relationship.

If your friend is currently suicidal, please seek help immediately. Page his psychiatrist, call a suicide hotline, take him to the ER, etc.

A good and reputable source for information about medications is rxlist.com. WebMD also has helpful and reputable articles that tend to be easy to read.

First off, everything that inkleberry said.

You said he was “recently” put on Paxil.

When my therapist and physician agreed that I should be on anti-depressants, I was warned that there was a good chance (not a definite chance) that I would be temporarily in greater danger for going through an “active” suicidal ideation, because there is a period when the SSRIs kick in and your energy goes up, but the imbalance isn’t completely corrected so the depression/suicidal tendencies are still there.

But mostly, everything that inkleberry said, including suggesting he see his doctor about changing his medication.

My wife, after trying numerous drugs to beat anxiety disorder and depression, has been on Paxil for several years.

It has saved her life, most likely, and certainly made it possible for her to live normally.

No, Paxil is not normally an anti-anxiety medication, but it seems to work that way for her.

One should never try to go off of Paxil cold turkey, because it has a really short half-life compared to other SSRIs, and can cause serious problems. Your friend definitely shouldn’t be mixing alcohol with it, but the suicide attempts could be from the drug. For example, stuides have shown that Paxil increased suicide attempts in children.
cite:
http://www.usatoday.com/news/health/2003-06-19-paxil-children_x.htm

#1- Children’s psychopharmacology is an ENITRELY different ballgame than adult psychopharm.

#2- Increased sucide attempts/gestures/actions have been noted for a long time as a by-product of medications. This is NOT because medications “cause” the suicidality, but rather, as noted before, the person has more energy and increased ability to make and carry plans before they have a substantial mood enhancement. Therefore they now can be actively suicidal where premeds they were too depressed for suicide. Think of it this way: pre-meds they were so depressed they no longer cared whether they lived or died, but for a certain period of time they stop being numb and feel pain again, which increases suicidality temporarily.

This is not new news, and isn’t related just to the SSRI class. Paxil has taken an unfair “hit” in this department, for a number of reasons not germaine to this thread.

Thanks for the responses.

there is this website; www.paxilprogress.org which seems to have been formed through a number of people that have had very bad reactions from this drug.

One arguement that was presented was that sometimes these drugs are too easily handed out.

What kinds of tests would one need to go through to determine whether or not Paxil is right for them? Can a family doctor just prescribe it?, or does a specialist have to make that call?

Thanks in advance

There is an “official” website for every Rx drug, and it will give you a full list of possible side effects (and how often they happen.) Often, there’s detailed info on testing they did. Just Google the name of the drug.

Never take a new drug without having all the info you can get.

First, I am not a doctor, nor am I medically trained. I just read a lot.

Any effective drug will cause adverse reactions to some portion of the people taking it. In your friend’s case, he is adding to the bad reactions by drinking alcohol and trying to withdraw from the Paxil without a doctor’s supervision. Alcohol is a depressant, and it’s not a good idea for any patient to mix alcohol and anti-depressants.

As for the website you mentioned, it seems to have a definite bias against Paxil. It also seems to be put together entirely by nonmedical people. I wouldn’t put too much stock in it.

Family doctors can prescribe Paxil and other drugs. However, many won’t. My own primary care doctor told me that she would write refills for my Paxil (and later Lexapro), but she wanted me to see a psychiatrist for the initial diagnosis and prescription. If your friend does not have insurance to see a psychiatrist, then he needs to look into the county’s Mental Health/Mental Retardation services. And he needs to quit drinking while he’s on antidepressants.

I’ve had hellacious experiences when I’ve missed doses of Paxil. I was able to withdraw under medical supervision, but I was put on another drug (at my request) while I was withdrawing, and had a much easier time of it.

This is why Paxil should only be prescribe by a psychiatrist who can moniter thr psychotrophic effects as well as medical.

To respond to your statements:

#1: The FDA is now recognizing the potential for similar effects in adults. cite: http://www.fda.gov/bbs/topics/ANSWERS/2005/ANS01362.html. While children and adults may have differences, our brains aren’t that dissimilar, and I think it’s a stretch to place them in “different ballgames.”

#2: Your explanation is ONE possible explanation, and possibly correct in some cases. However, many people taking these drugs have described experiencing self-destructive impulses or violent tendencies, that they never experienced before, or after stopping the drug. It is disingenous to place all the blame on the depression alone and ignore the possibility that drug itself might be the catalyst.

Paxil is a bugger of a drug if you go off it cold turkey - I’ve forgotten to refill my prescriptions and within 24 hours I feel effects similar to being drunk. Lightheadedness, dizziness, a sense of surrealness, tingling in my limbs and impaired sense of motion.

However, when I’m on it, it is definitely a lifesaver. I turn into an emotional wreck without it. To say the least, if my personality has changed because of the drug, it has been for the better.

All drugs give different effects for anyone. I’ve been on Paxil since I was about 10 (I’m 18 now). It is hard to remember what life was like before I was on it.

Oh. and no suicidal feelings. Not once. Then again, I never had one before I went on it, but it didn’t do any damage in that department.

#1- The brains of children and adults are fundamentally different even in regards to structure. This is most noted in frontal lobes, which are not complete in their development until the early 20s. Additionally, language areas, plasticity, and other structural differences exist. Then there are the chemical differences related to the hormonal changes of puberty, etc. (1)

#2- I have not seen any studies that bear out blame exclusively for Paxil per se, and prior to the “Paxil is the devil” fad we had the “Prozac makes kids killers” fad of the early/mid 90s. I again reiterate that any psychopharmeceutical drug should be given under the supervision of a trained psych professional- psychopharamacologist, neurologist, psychiatrist, etc, and not handed out by primary care physicians or OB/Gyns who have little training in psychology, psychopharm, and antidepressant assessment and use. Significant problems involving behavior, mood, and cognition will almost undoubtedly occur when even the most benign-seeming SSRI is given to a patient who has an underlying bipolar, schizophrenic, or neurologic disorder such as epilepsy. To blame the problems we are seeing on Paxil specifically is myopic and in the long-term dangerous, because the problems are symptomatic of the larger issue of scope of practice for psych meds, as well as the general safety of SSRIs as a class, something that has been overstated and should be called into question, IMHO.

But while Paxil has a bad rap, we’ve seen these reports involving Zoloft, Prozac, and Effexor for years. Not everyone with depressive symptoms needs or should be given a serotonin enhancing medication. Depression can and does have psychological, neurological, and biological roots in other causation, including norepinepherine problems, sleep apnea, social / behavioral issues, and a wide variety of other conditions. THis is why seeing a psychologist or psychiatrist for proper diagnosis is critical, even if you don’t wish for therapy. Primary care docs do not have the years of specific training needed for full psych assessment and diagnosis. Willy-nilly handing out of SSRIs will have large scale effects, and I think that’s what we are truly seeing.

(1)
http://www.pfizer.com/brain/etour3.html
http://mednewsarchive.wustl.edu/medadmin/PAnews.nsf/0/42FFB7C70822D54086256BC100612B11


http://serendip.brynmawr.edu/bb/neuro/neuro04/web1/epowell.html
http://www.nimh.nih.gov/publicat/teenbrain.cfm
Any neurology textbook

Depression can be fatal, so any medication risks must be weighed against the consequences of no treatment. All drug responses are individual.

I took Paxil for three years. I stopped drinking just before commencing, but did drink a lot on prozac without much effect, positive or negative. Paxil is approved for anxiety and obsessive compulsive disorders, and can be very helpful. Stopping was much more difficult than the doctors I saw wanted to admit. Tried googling paxil discontinuation syndrome and discovered there is a lot of evidence (mostly ignored by psychiatrists) going back to the original human trials of long term withdrawal effects. These include “electric shock” sensations, overactivation that may either induce or mimic hypomanic symptoms, disorganization, and since paxil’s worst side effect is sexual, can even feature a lots of horniness.

Quitting was horrible, dragged into months of odd mixed up irritable geeked up sensations, and of course, lots of anxiety. My shrinks refusal to read or acknowledge the literature aggravated matters. My family doctor was much better informed. On the other hand, it is quite a useful drug; just does not seem to be worth trying first (prozac is way cheaper now and its long half-life makes stopping easier). Anything that dramatically alters your brain chemistry carries consequences. Note that the FDA finally forced SmithKlineGlaxo to add a warning box to the drug info about the withdrawal problems.

Anectdote follows: I took Paxil for about 5 years. One time I stopped taking the drug due to a lack of communication with my doc. My Rx expired and I didn’t refill it. Within the first day or so, I started the “electric shock” sensations which progressed from bad to very bad. Within a week or so, I began to notice the psychological anxiety/depression symptoms returning. After returning to my doc and getting scolded for not coming in to renew my Rx, I returned to Paxil and the symptoms disappeared. I was doing very well on Paxil until this year when a bout with my boss landed me in a psych hospital for 3 days. I was started on Effexor and the only side effect is that I get tired more easily now.

I’m a social drinker and would drink beer/alcohol while taking Paxil with no ill effects. However, I was stable with the drugs and talk therapy. I wasn’t suicidal before, during, or after taking the drug.

As for your friend, I would certainly keep an eye on him; however, it may be difficult to sort out what is happening because of the drug vs. the underlying anxiety/depression. Paxil gave me back a great deal of my life that had been lost in the anxiety. Encourage him to return to his psych or family doc to talk about options. Perhaps Paxil isn’t the drug for him. Everyone responds differently and there are quite a few options these days. If he isn’t in talk therapy in addition to Paxil, encourage him to do so. The drugs alone will not be enough if he’s suicidal.

I was perscribed (prescribed?) Paxil when I was 8 when I was diagnosed with obsessive compulsive disorder. I am still taking it at 17, and I have never had any ill side effects or any suicidal impulses. In fact, it also takes care of my borderline depression that I inherited from my father. I’ll admit that I do drink from time to time, but I’ve never experienced any weird side effects or interactions with the Paxil and alcohol. (Although I wouldn’t know any better - I’ve never been drunk while not on Paxil.)

That said, once when I was about 13 or 14 my mom tried replacing the Paxil with St. John’s wort because apparently she saw something at work that said it has anti-depressant effects. (She’s an LCSW.) After a day or two of not taking paxil, I became really depressed, to the point of having to stay home from school. I dunno why, but all I can say is that it’s a bitch to quit it cold turkey.

I was on it for anxiety. Primarily social anxiety, but it worked for such things as calming my terror of heights too. It worked quite well. It eased the panicky feelings. I was able to start behaviors that allowed me to go off cold turkey (though cold turkey was -NOT- what the doctor recommended ). Anyway, my personal experience, what happened to just me, was that it was good. Helped my anxiety and no side effects.

As any drug, it depends upon the dose and the person and the condition it is trying to treat.